In the differential diagnosis of inadequate ultrafiltreation, one of the possible entities is a dialysate leak. The more insidious leak will present with weight gain and decreased drain volumes as the dialysate leaks into different planes/potential spaces and…
Is my peritoneal dialysis (PD) patient’s hypervolemia due to ultrafiltration failure (UF)? UF is a specific diagnosis with a definition of a failure to achieve 400 mL of ultrafiltration during a 4 hour dwell using 4.25% dextrose. While…
Welcome to post 4 of the “Let’s Talk About Peritoneal Dialysis (PD)” Series! In post 3 we discussed drain pain, and today we discuss infusion pain (pain during dialysate infusion into the abdomen) which can be just as distressing…
“Hey doc, it hurts every time I do this.” “Well, stop doing that.” Ah, if it were so simple. What is one to do when “this” is draining peritoneal dialysis (PD) dialysate? A simple question with a not…
A common call the nephrologist will receive when managing a peritoneal dialysis (PD) patient is that of poor flow. This problem is classically described as “one way” or “two way.” One Way Obstruction: Classically defined as as slow…
Welcome to a series of posts titled “Let’s Talk About Peritoneal Dialysis.” Today, we will be discussing the Peritoneal Equilibration Test (PET) that is performed in peritoneal diaysis (PD) patients. I distinctly recall my first time as a…
Peritoneal dialysis associated peritonitis is the second commonest cause of death among PD patients (35/1000 years) and the most common cause of treatment failure. It confers a CV risk of 7 times normal for 6 months following the…
My attention was caught by the recent article in CJASN which compared the mortality of peritoneal dialysis (PD) and hemodialysis (HD) patients in the first 2 years of dialysis therapy. When comparing survival outcomes of PD and HD…
Ultrafiltration failure is a frequent clinical problem in PD patients. The most common etiologies are: fast peritoneal membrane transport, loss of peritoneal surface membrane and high lymphatic absorption. Mechanical and anatomical etiologies are occasionally seen. Rule of 4’s…
The dates and locations for this year’s Home Dialysis University for Fellows have been released. This is a series of courses on home HD and PD aimed at graduating fellows that is sponsored by the ISPD. You can…
